The threat of carbapenem-resistant gram-negative bacteria in a Middle East region

Davoudi-Monfared, Effat; Khalili, Hossein

doi:10.2147/idr.s176049

Cited by 22 publications

(15 citation statements)

References 65 publications

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“…The increase in carbapenem resistance in clinically important GNB gradually worsened after 2005, particularly in GNB isolates cultured from patients hospitalized in the intensive care unit (ICU) ( Davoudi-Monfared and Khalili, 2018 ). For example, from 2007 to 2008, Iran reported high imipenem resistance and MDR rates (41.8% and 56.3%, respectively) among P. aeruginosa isolates, especially those carrying class 1 integrons, or those cultured from patients undergoing surgery or hospitalized at the burn unit ( Yousefi et al., 2010 ).…”

Section: Global Trends Of Carbapenem Resistance Among Important Gnb S...mentioning

confidence: 99%

Global Threat of Carbapenem-Resistant Gram-Negative Bacteria

Jean

Harnod

Hsueh

2022

Front. Cell. Infect. Microbiol.

139

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Infections caused by multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacteria (GNB), including carbapenem-resistant (CR) Enterobacterales (CRE; harboring mainly blaKPC, blaNDM, and blaOXA-48-like genes), CR- or MDR/XDR-Pseudomonas aeruginosa (production of VIM, IMP, or NDM carbapenemases combined with porin alteration), and Acinetobacter baumannii complex (producing mainly OXA-23, OXA-58-like carbapenemases), have gradually worsened and become a major challenge to public health because of limited antibiotic choice and high case-fatality rates. Diverse MDR/XDR-GNB isolates have been predominantly cultured from inpatients and hospital equipment/settings, but CRE has also been identified in community settings and long-term care facilities. Several CRE outbreaks cost hospitals and healthcare institutions huge economic burdens for disinfection and containment of their disseminations. Parenteral polymyxin B/E has been observed to have a poor pharmacokinetic profile for the treatment of CR- and XDR-GNB. It has been determined that tigecycline is suitable for the treatment of bloodstream infections owing to GNB, with a minimum inhibitory concentration of ≤ 0.5 mg/L. Ceftazidime-avibactam is a last-resort antibiotic against GNB of Ambler class A/C/D enzyme-producers and a majority of CR-P. aeruginosa isolates. Furthermore, ceftolozane-tazobactam is shown to exhibit excellent in vitro activity against CR- and XDR-P. aeruginosa isolates. Several pharmaceuticals have devoted to exploring novel antibiotics to combat these troublesome XDR-GNBs. Nevertheless, only few antibiotics are shown to be effective in vitro against CR/XDR-A. baumannii complex isolates. In this era of antibiotic pipelines, strict implementation of antibiotic stewardship is as important as in-time isolation cohorts in limiting the spread of CR/XDR-GNB and alleviating the worsening trends of resistance.

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Section: Global Trends Of Carbapenem Resistance Among Important Gnb S...mentioning

confidence: 99%

Global Threat of Carbapenem-Resistant Gram-Negative Bacteria

Jean

Harnod

Hsueh

2022

Front. Cell. Infect. Microbiol.

139

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“…In this survey, we found only 16.6% of mCIM positive isolates were carried bla oxa−48 -like gene, indicating other mechanisms such as metallobetalactamases or OmpK gene that regulates expression of mutated e ux pump are involved in carbapenem resistance. These discrepancies on phenotypic and genotypic results are also cited by some authors [13,33,[40][41][42].…”

Section: Discussionmentioning

confidence: 85%

“…The mCIM is a reliable and simple method and has a sensitivity of 98-100% in comparison with the modi ed Hodge test and the carbapenemase Nordmann-Poirel (carba NP) test with sensitivities of 93-98% and 73-100%, respectively. Furthermore, due to being expensive of PCR, mCIM could be a suitable alternative method for detecting of carbapenemase producers [12,[31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Emergence of OXA-10 and OXA-48 like carbapenemases among Enterobacter isolates from inpatients in southern Iran

Moradi

Khashei

Malekzadegan

et al. 2021

Preprint

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Background The global spread of carbapenemase-producing Enterobacteriaceae represents a public health concern. The aim of this study was to investigate prevalence of carbapenem resistance, oxacillinase types and the presence of class 1–3 integrons among Enterobacter clinical isolates from an Iranian inpatients’ population. Methods Ninety Enterobacter isolates recovered from hospitalized patients were diagnosed by the standard microbiological methods. Antibiogram pattern was also determined. The presence of class 1–3 integrons and four types of oxacillinase genes were assessed using PCR. Results Of the 90 Enterobacter isolates, the most common species was identified as E. aerogenes, (45.6%), followed by E. cloacae (30%). The highest resistance rate was against to ampicillin (96.7%). Multi-drug resistance (MDR) was substantial (93%). Carbapenemase producers were detected in 96% of carbapenem resistant isolates by mCIM test. The frequency of evaluated genes was as follows: intI1 = 50 (55.6%), intI2 = 12 (13.3%), blaoxa−1 =6 (6.7%), blaoxa−2 =5 (5.6%), blaoxa−10 =18 (20%), and blaoxa−48 =18 (20%). Conclusion The determinants of class 1 integron with OXA-10 and OXA-48 like carbapememases have been responsible of relatively considerable of carbapenem resistance among isolates. This is the first OXA-10 and OXA-48-producing Enterobacter spp. in Iran, indicating that the prevalence of oxacillinases might be on the rise in country.

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“…Table (2) demonstrates results of carbapenem susceptibility, mCIM, and bcCIM in different isolated GNB.…”

Section: Resultsmentioning

confidence: 99%

“…The irrational wide use of antimicrobials, especially in developing countries, leads to the emergence of variety resistant GNB. The identification of these resistant phenotypes is mandatory for the proper implementation of infection control measures and better strategies for early patient management 2 .…”

Section: Introductionmentioning

confidence: 99%

Detection of carbapenemase production by blood culture carbapenem inactivation method (bcCIM) compared to modified carbapenem inactivation method (mCIM) in bloodstream infections

Abdallah

2021

Egyptian Journal of Medical Microbiology

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Background: Early detection of bloodstream infections (BSIs) caused by carbapenemase-producing organisms can guide rapid lifesaving appropriate therapy.A new variant of the modified Carbapenem Inactivation Method (mCIM) test, named blood culture CIM (bcCIM), can directly detect carbapenemase enzymes from positive blood culture. Objective: This study aimed at comparing detection of carbapenemase activity in Gram-negative bacilli (GNB) by Carbapenem Inactivation Method on positive blood culture and isolated colonies. Methodology: bcCIM test was used to detect carbapenemase production in 38 positive blood cultures. Subculture of blood samples followed by isolation and identification of causative pathogens was done, antimicrobial susceptibility by disk diffusion test as well as performing mCIM test were applied to all isolated GNB. Results: Forty-one GNB were isolated. Klebsiella spp. was the most common isolated GNB 16 (39%). Most isolated GNB were carbapenemresistant 31(75.6%). For monomicrobial bloodstream infection, there was fair (kappa =0.327), moderate (kappa=0.429), and slight agreement (kappa=0.158) between results of mCIM and results of bcCIM as regards all GNB, Enterobacteriaceae, and Pseudomonas, respectively. Conclusion: bcCIM is a promising test for direct detection of carbapenemase activity, particularly in carbapenem-resistant Enterobacteriaceae. Further studies are needed for the standardization of this method.

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The threat of carbapenem-resistant gram-negative bacteria in a Middle East region

Cited by 22 publications

References 65 publications

Global Threat of Carbapenem-Resistant Gram-Negative Bacteria

Global Threat of Carbapenem-Resistant Gram-Negative Bacteria

Emergence of OXA-10 and OXA-48 like carbapenemases among Enterobacter isolates from inpatients in southern Iran

Detection of carbapenemase production by blood culture carbapenem inactivation method (bcCIM) compared to modified carbapenem inactivation method (mCIM) in bloodstream infections

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